This is the easiest way to monitor the heart rate: how to take your pulse correctly?

The feeling that the heart is beating too hard in the chest, that it is racing, that its rhythm is irregular: this can be a sign of atrial fibrillation, a disease which affects 750,000 people in France and which is often difficult to be diagnosed because it is said to be “silent”, ie without easily identifiable symptoms or which only manifests itself by signs that are apparently not serious. And yet, simple palpitations can hide AF with the major risk that accompanies it, a cerebrovascular accident.

To detect the reality of a cardiac arrhythmia that may be due to atrial fibrillation, there is a very simple gesture to perform: taking a pulse. “There is no other way to know if you have a cardiac arrhythmia than to take your pulse”, explains Dr Mathieu Kerneis of Pitié-Salpêtrière in Paris.

But if this gesture seems simple, it still has to be done in the right way so that the heart rate and its possible anomalies are well controlled. There are two classic methods recognized as effective for measuring the heart rate from the pulse measurement:

– Either you take your index and middle fingers and put them at the level of the small gutter which is under the thumb, you then feel a pulsation which allows you to measure your heart rate.
– Either, and this is another way to take your pulse at the level of the carotid, you can put three fingers, the middle finger, the index finger and the ring finger, just next to the trachea.

There are also digital tools today that allow you to see even more precisely if the heart rate is good, these are all the tools, connected or not, such as watches or bracelets used by athletes who measure live and constantly the heart rate. Doctors find them very useful for regular heart rhythm monitoring in patients with atrial fibrillation.

In any case, it is then enough to … count! How many pulsations felt in one minute (we can also, it’s arithmetic, count the pulsations during 15 seconds and multiply by 4).

Between 50 and 100 beats per minute

But beware, it is more the irregularity of the heartbeat that signs the presence of atrial fibrillation than its frequency. It is usually said that a normal pulse should be between 50 and 100 beats per minute. Below 50 beats, the heart rate is too slow. However, this can be normal for people who are very athletic and at rest. But the rhythm should never drop below 40 beats. Up to 100 beats per minute, this remains normal if you have just made an effort, but beyond that, it is too fast and we speak of tachycardia. “When the rhythm clearly exceeds 100 beats per minute, there is a heart rhythm disorder, an electrical anomaly in the heart which should lead you to consult”, underlines Dr. Mathieu Kerneis.

The risk of blood clots forming

“At rest, you don’t feel your heart beating. When you start to feel it beating, this is called palpitations, when the heart beats quickly and irregularly,” adds Dr. Kerneis.

Cardiac arrhythmia, the main sign of atrial fibrillation, is linked to “electrical” abnormalities that cause the atria to contract very quickly and irregularly. And as they contract too quickly to ensure good blood circulation, it stagnates in these atria and ends up forming clots.

It is these clots which, in atrial fibrillation, pose the greatest risk: if they travel to the vessels that supply the brain, they can block an artery and cause a stroke. Hence the importance, in prevention, of knowing how to take your pulse to check that the heart rate is normal or to identify when it becomes abnormal.

To treat this risk of clot formation, the prescription of anticoagulant drugs is the main pillar of the management of atrial fibrillation.